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Huntington's disease: the role of dentistry in the multidisciplinary team Emma Critchley Finbar O'Mahony Elizabeth Lemon Angela Adkins Dental Update 2024 49:7, 707-709.
Authors
EmmaCritchley
BDS, MFDS (Edin), DSCD, MSc (Rest), MSCD (Edin)
Speciality Registrar Special Care Dentistry, North West Deanery, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley and South Ribble Hospital
Huntington's disease is a progressive, genetic disorder, leading to changes to cognition, movement and behaviour. The oral health of these patients can rapidly deteriorate if they are not assessed and managed early. This article explores the role of the dental team, as part of the multidisciplinary team, in caring for Huntington's disease patients. It highlights some of the challenges in providing oral care for this complex group, along with a pathway of care, used by one Special Care Dental Team, in helping to reduce oral complications.
CPD/Clinical Relevance: It is important for GDPs to understand the oral health needs of patients with Huntington's disease and their role in supporting the oral health of these patients.
Article
Huntington's disease (HD) is a hereditary, neurodegenerative disorder caused by a mutation in the huntingtin gene,1,2 found on chromosome 4.3 This mutated gene affects the production of an important protein required by neurones in the central nervous system.1,2 HD is inherited in an autosomal dominant pattern,3 which means any children of HD gene carriers have a 50% chance of inheriting the mutated gene.4
The classic sign of HD is chorea (involuntary, jerky movements) that gradually progresses to all muscles;2,3 however, it is not only muscle movement that is affected, and changes in cognition and behaviour are also seen.1 Early signs and symptoms can include irritability, depression, poor coordination, slight involuntary movements and problems with short-term memory.1,3,5 As the disease advances, these involuntary movements become more pronounced, and walking, talking and swallowing become increasingly problematic.2 Cognitive abilities decline and many patients develop dementia.6 Over the course of the disease, daily activities, such as tooth brushing, cleaning and eating, become more challenging and patients become more dependent.2
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